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wooh 37,130 Views

Joined: Feb 12, '04; Posts: 4,977 (74% Liked) ; Likes: 20,737
RN & Critter Mama; from US

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  • Sep 12 '14

    i suspect than an icu nurse who looks down on a med/surg nurse is someone who has never worked anywhere other than icu. i've worked med/surg, and i'm too old to work that hard any more!

  • Sep 11 '14
  • Sep 11 '14

    Quote from Lazydaisy

    My hospital used to give 'bucks' out for things. We had coins worth a buck to use in the cafeteria and buck ones that you could cash in for $20 gift cards once you got 5. But times got tight... Now each patient gets a letter from the hospital foundation that states if an employee did an exceptional job for them, they may donate money to the foundation in that person's name.
    Wow. you have to kind of admire the pure evilness of the person wh came up with this one.

    This would make Catbert, the Evil Director of Human Resources, purr like crazy.

  • Sep 11 '14

    Quote from sistrmoon
    That last bit is part of our scripting. Yay, scripting.
    "I have the time." is part of our scripting too. Along with "I want to provide EXCELLENT care to you" and "Thank you for allowing me to provide EXCELLENT care to you." Love those Press Ganey scores.

    My hospital used to give 'bucks' out for things. We had coins worth a buck to use in the cafeteria and buck ones that you could cash in for $20 gift cards once you got 5. But times got tight... Now each patient gets a letter from the hospital foundation that states if an employee did an exceptional job for them, they may donate money to the foundation in that person's name.

  • Sep 11 '14

    Quote from scaredsilly
    17 year old kids aren't going to research, they are going to trust what they are told. Also, I was single, I got married in school to a man who works for the government here. I did not know I couldn't move when I was 17!
    Speak for yourself...

    There are many freshmen and sophomore HS students that post here for guidance in being involved in this business; I also shared in my previous post I did the research SOLELY for my higher education; not my parents; they had no idea, because times were changing, even in my area they were closing down hospitals, this was the mid-late 1990s because of the economy back then was up in the air and there were reimbursement issues back then-sound familiar?

    One parent worked for the government, the other was a military veteran; I was very cognizant of what they couldn't offer.

    Also, I was all aware of the possibility of having to work at the same job when I went back for my BSN; I went to a job fair and they had told several new ADN graduates that they were preferring to higher only ADNs and/or BSNs with experience; even more so BSNs (I was an LPN back then; they were still hiring LPNs); I took that piece of information and ran with it; and sought out a BSN program;?what also helped is my school was VERY upfront and honest about the challenges in the local market.

    I also understand that you were "only doing what I was told", unfortunately you are reaping those lessons as of now; only you can decide what and how you proceed with those hard lessons when it comes to anything else that happens in life as anyone else would.

  • Sep 11 '14

    Quote from Esme12
    All of the contributions, comments, and thoughts were heard, are being discussed and incorporated. That is what I have always liked about AN....they LISTEN.
    I'm glad to hear that - for next time. For now, well....... it's out there. Nothing we can do about it now. It just makes me sad (and angry) that the perception is out there that we at compare ourselves to television shows. As I said in my inital post, that was what made me question the validity of the survey and my willingness to participate in a bunch of silliness linking real nursing to TV nursing. What a demeaning question in what purported to be a serious look at nursing.

    Let's just say I will no longer be urging my peers to take a look at as I have in the past. Maybe we'll gain some new lurkers from fans of Grays Anatomy.

  • Sep 11 '14

    Quote from JustBeachyNurse
    Why can the RT recommend an in hospital solution or come up and advise the nurse as to what is needed? Such as we could switch to our machines with an order or have CM call DME to send out their RRT/biomed to troubleshoot the machine (or send the new mask if that's all that's broken). We all know patients are great at doing PM checks on equipment at home (lol). Some RTs say nope not my problem others say "policy states we can't work with home equipment we need to either get an order to switch to our equipment or have CM call DME vendor"
    The OP (nurse) knew what was needed which was the mask. The hospital masks will not work. The OP also stated if the hospital machine is used the patient must be in the ICU. That means the hospital has only the big rescue CPAP machines.

    Why do you keep harping like the RT is the enemy here? The nurse obviously is not stupid and saw the mask is the problem. Does she really need an RT to also say the mask is broken? Does that change what can and can not be done? I have explained over and over and included links with pictures to show the mask differences. The OP just wanted someone to side with her when the RT tried to explain why the masks are different. The OP didn't understand vented vs nonvented masks, exhalation ports, circuit differences and CO2 in the mask if no vents or exhalation port. Hopefully she does now and will move on to either transferring the patient to ICU and calling the CM for an ETA on a new mask.

    Essentally the wavier you get the patient to sign says "not the hospital's problem". Those are not words the RT made up nor did that RT write the protocol. What else do you think they can do especially if you act as if you don't know the policy and just want to argue about all masks being the same. Instead of listening to the RTs explaination about why the nurse just wanted to disagree essentially to get on a forum to start trash talk about the RT. I can now easily see how frustrated the RT was when he did try to explain it and came up against someone who wouldn't listen to the whys or the alternative which could be provided by the policy. Work to change things later but for now start the ball rolling according to what your hospital's policy dictates. I'm sure there are policies in nursing you don't like also but must abide by them. This policy of moving the patient to ICU is not the RT's fault. And don't make the RT out to be a villian because he refuses to put the incorrect mask on a home CPAP unit which will cause harm to the patient.

  • Sep 11 '14

    Quote from smartnurse1982
    For people saying it does not provide privacy,what makes you think the nursing home/ALF has more privacy?
    I don't necessarily think this has more/less privacy then ALF/NH, but it has the potential to have less. I wonder if they can turn it off when they wish to? In a NH you can close your door for privacy. How can you turn off a camera?

    What if family members use this as a way to control/abuse their elderly parents/grandparents?

    If a person agrees to this and wants it in their home then I suppose they have the right to make that decision. I agree with other posters though that if someone requires this level of monitoring then perhaps they need a higher level of care. Home health, meals on wheels, life alerts, those are all potential ways to keep someone at home and independent. Not sure this level of surveillance is a good idea. Just my feelings.

  • Sep 11 '14

    if the dose is less than the smallest stocked dose in the pyxis, you have to take that vial and waste the overage...

    Quote from BuckyBadgerRN
    How are you allowed to withdraw MORE than the ordered dose? And I'm sorry, to say, it looks damned suspicious to me as well =(

  • Sep 11 '14

    Some people go into nursing because they felt drawn to it, "called" if you will, and always knew they always wanted to be a nurse. And then discovered they hated it.

    Some people go into nursing because after an unsatisfying career in their 20's or 30's, they wanted to do something meaningful but still earn a decent paycheck. And then discovered they hated it.

    Some people go into nursing because they were tired of being downsized, losing job prospects because of outsourcing, and had a degree in something no one found of use; they needed a good job. And then they discovered they hated it.

    Seeing a theme yet? Point is, people LOVE or HATE nursing REGARDLESS of whether they felt they always wanted to do this and nothing else ("it's my calling!!"). They also LOVE or HATE nursing REGARDLESS of WHY they went into it.

    Saying that people who go into it for the money are the ones who end up hating it is short-sighted, half-truthful, and tends to be the opinion of the over-idealized. Those with real, hard-earned experience in nursing KNOW that the only reason to stay in nursing is either you really deep down like/enjoy/love what you do.....or you can't find a job anywhere else (only half-kidding on that!).

    People who seem to just 'know' who went into nursing for the love of selflessness and who did it to put food on the table are frequently wrong. I can personally point out nurses whom I know do it for THE JOB, they don't love it, but they are professional to the core and perform very well in their duties. I guarantee you the patients don't know who wanted to be Nurse Nancy from the time she was five and who was a single mother who found a way to support her kids, period.

    Me? I went into nursing because the description seemed a good fit with my personality, lifestyle, educational background, experience, and....well....I thought I'd be good at it. I think I was right

    Some jobs I've loved, some hated. Never ONCE regretted becoming a nurse, but to say that I'm in love with nursing 24/7....or that ANY nurse with an actual license IS.....would be a lie. Sometimes, over the course of ONE day, I love Patient X but kinda want to find a legal way to off Patient Y. And their mother, brother, and girlfriend who is an EMT.....but I digress.

    Decide for yourself, OP. What do you like about it....and what you like, is it REALITY, or TV? Be careful, make sure you know the difference. And if you feel like it's something you still want to do...DO it! What's the worst that can change careers later in life? Most people do

    Best of luck, whatever you decide.

  • Sep 11 '14

    Quote from exit96
    Of course, but they ARE NOT the same. Come on...
    No one said race and gender are the same; they implied race and gender are comparable, and by definition, they are.

  • Sep 11 '14

    Quote from sunny3811
    Because they see themselves in them & it may scare them that they are like that.
    I must say that I find that analysis a bit overly generalized and simplistic. Personally I had to edit my post and add a paragraph questioning the relevance of the description of the nurse’s physical appearance, when it finally registered.

    What conclusion do you draw from that? That I’m beautiful and skinny and didn’t feel like OP’s rather harsh description had anything to do with me? Or is the answer that I’m overweight and ugly as a toad, yet comfortable in my own skin? Or perhaps I’m simply not a very attentive reader?

    There are likely many different reasons why people perceive and react to a specific post in a certain way. Just as there are many reasons why someone else in turn reacts to the reaction the way they do.

    My thought process when initially reading the post was that I wondered what motivated OP to write it, and what the desired outcome was (I kind of still do ). Not important enough to voice, just something that I filed away in the back of my mind.

    The other reflection I made, in private, was that the antagonist in this narrative displayed a rather inconsistent behavior. Crude language and a loud, confrontational attitude coupled with a nit-picking disposition I personally associate with a completely different type of person. These “do everything by the book” type personalities in my experience, normally show more restraint in body language and tone. I thought it was an oddity. I’ve encountered both types of behavior, just not in the same person.

    What do my thought processes tell you? Apart from the very obvious fact that I spend too much energy analyzing inconsequential stuff on the internet?

    How much do I weigh, how do I look, am I a bully? Am I scared that I might be one?

  • Sep 11 '14

    Quote from BonhamsGhost
    Sorry, i understand and agree with the provider and witness being in the room. Why didnt the nurse simply state that it was for legal purposes? Not "I have the right to be in here!" That is obnoxious!!
    Whose to say what she said? Communication is 30% interpreted through delivery, less so when one is anxious or upset.

    We weren't there; maybe the delivery may have been off, but the nurse does have the "right" to be in the room for the pts PROTECTION.

    OP, I think your going to have a challenge at times requesting a male nurse; however you do have a right to make a request; it's unfortunate that you have had a negative encounters when asking for it; it is usually not this way, at least in my experience, and when the accommodations couldn't been made, respect and modesty was upheld.

    Hoping for you to have a better experience in your healthcare encounters.

  • Sep 11 '14

    Quote from icuRNmaggie
    to GrannyRRT,

    Why should the nurse be responsible for obtaining parts for respiratory equipment such as ordering a new home CPAP mask?

    Shouldn't the RT be the one to troubleshoot the problem?

    When the RT says "I don't know responsibilityto tell ya" in these home CPAP situations, they really do, they just don't want to be bothered?

    If they know the policy doesn't exist why dump it in the nurses lap? What's that about?

    Sorry for being snarky but it is very very frustrating.
    The OP asked for a face mask and assumed that since patients with CHF got CPAP, all maks were tne same. The RT said the masks would not work. It should be clear that you don't rig up homecare equipment. In hospitals which allow patients to bring in their machine and don't have alternative change out policies should have the wavier saying RTs nor RNs will not touch their equipment . Period. We touch and patient can say we broke it or made the situation worse. You are also asking someone to troubleshoot equipment they are not familar with. I don't know how to make that any clearer to you. It is not the RTs responsibility to fix home equipment. The machines the RTs use are for the ICU so the patient would need to be transferred. The RT essentially gave the OP the policy. The patient has a responsibility for his equipment and it may cost him an ICU charge.

    Telling the RT to do something against policy like setting up equipment he knows not to be appropriate or safe is much more snarky and disrespectful.

    Having you call the CM is also not dumping and really shouldn't burden you that much.

    No fraud would be committed since the policy is to place patients requiring the use of their big ICU CPAPs in the ICU. To go against a policy and put that machine on a med surg floor would be a very serious offense for the RT and for the nurse to assume responsibility for it which she is not trained for.

    You should not force an RT to do something against policy or try to make something fit knowing it is not the appropriate mask or alter a home machine which is a given for any home DME equipment.

    If a doctor tells you to push a cardiac med without a monitor on your floor against policy do you consider yourself snarky to say no?

    Respect the policies in place and don't expect someone to violate it. The hospital should have other options but this one apparently doesn't. If it did the RT would probably just bring up his machine, provided the patient has a sleep test result on file along with a doctor's order.

    Of course the one other option is to call the doctor and have him call the Medical Director (usually the CC Director) who wrote the policy and argue. But, in the meantime CALL THE CASE MANAGER for a definitive solution. DMEs will expedite a hospital order. Fix the problem for the patient who did not take the initiative to maintain his equipment thus violating his patient responsibiliy agreement.

    I think it is ridiculous for hospitals to ignor sleep medicine but many do not see it as an issue. Many doctors will say just pt the patient on a couple liters of oxygen for the night if there is no other alternative available. That is what we did before they allowed any CPAP machines on the floor. Not the best answer but then I am not at your hospital to advocate for a policy change.

    A nurse also bears some responsibility to know the policy concerning home equipment accepted on their floor.

  • Sep 11 '14

    To GrannyyRRT - I agree with icuRNmagie that this has been a very informative and thought provoking discussion.

    In my LTC experiences, I've often thought about some of the issues you bring up re cleanliness, maintenance/safety, equip integrity, etc. Nobody else has seemed to question the use of machines from home. NOBODY questions the equip reliability and efficacy. At least in the acute setting, you have a Respiratory Dept. We struggle in LTC.Icouldn't even begin to fathom how to address our circumstances.

    But you have brought up some thoughtful issues.